The objective of this Clinical Mental Health Academic Award application is to assist Dr. Thomas Smith in his academic activities in the field of schizophrenia and to develop a schizophrenia clinical research program at The New York Hospital Cornell Medical Center, Westchester Division. The primary focus of this program will be to investigate factors that influence recovery and community reintegration of treatment refractory schizophrenic patients. The development plan described in this application outlines a program of tutorials/seminars, consultations with notable scholars, and feasibility studies that will allow Dr. Smith to become an academic resource and rigorous clinical investigator. The award will free Dr. Smith from most of his present responsibilities and permit him to: a) develop skills in the assessment of psychotic symptoms and neuropsychological deficits in schizophrenic patients; b) become an expert in the assessment and treatment of social skill deficits commonly seen in chronically psychotic patients; and c) conduct a research project studying the combined effects of the atypical antipsychotic medication clozapine and a manualized symptom management social skills training program on symptom control, social skill, and social adjustment in a cohort of treatment refractory schizophrenic patients. With this training Dr. Smith will assume an important role in the Cornell University Medical College Department of Psychiatry as an expert regarding the assessment and treatment of refractory schizophrenia. Given the severity of this illness, the strong desire of patients and their families for active, community- based treatment, and the current economic constraints that potentially limit the availability and quality of care for schizophrenia, the development of Dr. Smith as an academic resource leading a sophisticated clinical research program will have important long-term benefits. Dr. Smith will function as an educator and mentor to junior faculty interested in pursuing research in schizophrenia, and will organize courses and seminars for medical students, psychiatric residents and psychology interns at Cornell University Medical College. Academic and research activities will take place throughout the award period. As a result of these efforts, hypotheses regarding the underlying relationships between psychotic symptoms, neuropsychological deficits, learning capacity, and social adjustment in schizophrenia will be formulated. After the award period Dr. Smith will become a recognized researcher in the treatment of chronic schizophrenia and function as a faculty scholar, fostering the career development of medical students, residents, fellows and colleagues.